SUBOXONE, a medication that combines buprenorphine and naloxone is a film administered by placing under the tongue. Buprenorphine HCl is a mu-opioid receptor partial agonist and a kappa-opioid receptor antagonist. Naloxone HCl dehydrate is an opioid receptor antagonist. Suboxone is considered "safer" than other opioids, because of its respiratory depression "ceiling effect" that limits the risk of death by overdose. However, this ceiling effect that protects a patient from lethal respiratory depression can be affected by the use of other medications.
Preclinical studies have shown that the combination of benzodiazepines and buprenorphine alter the usual ceiling effect on buprenorphine-induced respiratory depression, making the respiratory effects of buprenorphine appear similar to those of full opioid agonists, like methadone. Deaths from suboxone combined with benzodiazepines like Xanax, valium, and Librium have been documented, and the medical literature warns against using these medications concurrently (at the same time). If you suspect a loved one has died because of a suboxone overdose, you should contact a lawyer to explore whether there was a hospital or physician error.